Laparoscopic adjustable silicone gastric banding: radiological appearancesof a new surgical treatment for morbid obesity

Background: The purpose of this report is to describe the radiologic appear ances of laparoscopic adjustable silicone gastric banding (LASGB), a new su rgical treatment for sas morbid obesity, In this procedure, a silicone band is fastened around the fundus, delimitating a small proximal gastric pouch and stoma, The inner surface of the band is inflatable and connected by a thin silicone tube to an access port. This allows postoperative stoma size adjust ment by puncturing the port and injecting or withdrawing saline solu tion. Methods: One hundred eighty patients underwent LASGB. A radiologic study pr otocol was established and performed in all patients, including preoperativ e double-contrast upper gastrointestinal (GI) series and single-contrast up per GI series on the first postoperative day and 1 month after surgery. Rad iologic evaluation was also performed at each band adjustment and in case o f persistent vomiting or inadequate weight loss. Results: Postoperative stoma adjustment was performed in all patients. The optimal volume of saline was 1-4.5 mt. Percutaneous puncture of the port wa s impossible in three patients because of an inverted port. We observed 15 cases of pouch dilatation with stomal obstruction requiring reoperation. Th ere were also nine cases of spontaneous band deflation caused by leaking re servoir in five cases and by disconnection between the connecting tube and the port in the other four cases. Conclusions: Because radiologic evaluation is necessary after surgery and f or band adjustments, radiologists are involved in the postoperative follow- up and may be asked to perform those adjustments themselves.